The Efficacy of Dexmedetomidine alone or with Melatonin on Delirium after Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial.

Background: One of the most common cognitive disorders after major surgery is delirium which can increase morbidity and mortality. This study compared the effect of dexmedetomidine with or without melatonin to reduce delirium following coronary artery bypass graft (CABG) surgery. Methods: This trial was a double-blind, randomized, controlled clinical trial. Eighty patients in two different groups with the administration of dexmedetomidine alone or with melatonin undergoing CABG surgery in Golestan Hospital, Ahvaz, 2022 - 2023, were randomly allocated. This study evaluated the occurrence, onset, and length of delirium, haloperidol, the time required for weaning, and the duration of stays in the intensive care unit (ICU) and hospital. Results: The occurrence of delirium was lower in the melatonin/dexmedetomidine group (15%) than in the dexmedetomidine group (30 %) (P = 0.09). Additionally, the melatonin/dexmedetomidine group had a significantly lower duration of delirium than the dexmedetomidine group (1.95 (0, 20) and 8.46 (0, 40) P = 0.04). However, no significant difference was observed in the onset of delirium between the two groups (P = 0.25). The length of hospital stays in the melatonin/dexmedetomidine group was significantly shorter than in the dexmedetomidine group (7.53 (7, 10) and 8.60 (7, 15), P = 0.03). However, the two groups demonstrated no significant difference between extubation (P = 0.38) and length of ICU stay (P = 0.19). Conclusions: The administration of melatonin and dexmedetomidine reduced the incidence of post-cardiac surgery delirium, shortened its duration, and decreased the impact of many risk factors observed in those not receiving the added melatonin.

Development and Psychometric Evaluation of the Clinical Nursing Cultural Competence Scale.

Background and Purpose: Cultural competence in clinical nurses can lead to comprehensive care for patients from different cultures. Currently, an appropriate instrument to assess cultural competence in clinical nurses is limited. This study aimed to design and determine the psychometric properties of the clinical nursing cultural competence scale (CNCCS). Methods: This methodological study was conducted in 2018-2019 in two phases. In the first phase, a literature review and semistructured interviews with 18 clinical nurses from Isfahan and Ahvaz were conducted, and the results were used for item generation. In the second phase, the face, content, construct validity, and reliability of the questionnaire were assessed. For construct validity assessment through exploratory factor analysis (EFA), 200 clinical nurses were purposefully recruited to fill out CNCCS. Results: In the first phase, 140 items were produced. In the second phase, the item number was reduced to 40 after the face and content validity assessment. In EFA for construct validity assessment, 13 more items were deleted, and the remaining 27 items were loaded on six factors. The Cronbach's alpha and the test-retest intraclass correlation coefficient were CNCCS 0.86 and 0.93, respectively. Conclusions: The CNCCS had acceptable psychometric characteristics in Iranian nurses and can be used for assessing cultural competence among clinical nurses. The use of this scale can help nursing policymakers and managers develop their understanding of nursing cultural competence and develop strategies for its improvement.

The Evaluation of Effects of Electrical Stimulation in Treatment of Patients with Chronic Tinnitus with Normal Hearing Sensitivity.

Tinnitus is usually associated with different comorbidities such as anxiety, annoyance and depression. Evidences have targeted two main places for tinnitus treatment, namely the auditory cortex and the dorsolateral prefrontal cortex (DLPFC). Transcranial direct current stimulation (tDCS) has been reportedly associated with improvement of cognitive functions in individuals. This study was conducted to evaluate the therapeutic effects of repeated sessions of anodal bifrontal tDCS on tinnitus symptoms. Furthermore, the tDCS impacts on the comorbid depression and anxiety of the patients were investigated. Forty-two voluntaries that suffers from chronic tinnitus were randomly assigned into "real tDCS" (n = 21) and "sham tDCS" (n = 21) groups. The tDCS group, received tDCS with the protocol consisted of 2 mA current, daily one session of 20 min, 6 consecutive days per week and for 4 consecutive weeks. The tinnitus handicap inventory (THI) scale, was measured before the first tDCS session and at one-week and two weeks follow-up. With the same intervals; the distress-related tinnitus was evaluated using visual analogue scale. Depression and anxiety scores were also measured using the Beck depression inventory and Beck anxiety inventory scales, respectively. Our findings indicated that THI score, depression and anxiety level has been gradually diminished across subsequent measurement intervals. We also find significant reduction of distress-related tinnitus in the real-tDCS group after treatment. We conclude that application of tDCS to the bilateral DLPFC region alleviates chronic tinnitus and it should be considered in patients with refractory tinnitus.

Effectiveness of Using Face Masks and Personal Protective Equipment to Reducing the Spread of COVID-19: A Systematic Review and Meta-Analysis of Case-Control Studies.

Recently published researches show that 59% of all transmission came from asymptomatic transmission and at the time of diagnosis health-care workers (HCWs) tend to present without respiratory symptoms. These evidences have raised questions on whether an essential policy for use of personal protective equipment (PPE) is the best approach in HCW and other people or not. Therefore, this study conducted to investigate the effectiveness of using face masks and PPE in reducing the spread of COVID-19 in health-care and non-health-care settings. This systematic review and meta-analysis study was prepared according to the preferred reporting items for systematic review and meta-analysis statement and guided by meta-analysis of observational studies recommendations. Searches in databases were conducted from December 2019 to July 2021. Random-effects meta-analysis was performed to investigate the effect of using face masks and PPE on spread of COVID-19. Heterogeneity among studies was assessed using Cochran's Q test and the I 2 metrics. In total, 9920 individuals from 14 studies were included in this study. In all settings, application of PPE or any type of masks was associated with reduction in risk of COVID-19 (odds ratio [OR] = 0.44; 95% confidence interval [CI]: [0.29, 0.65]; I 2 = 85.21%). In the HCW subgroup, the protective effect had a combined OR of 0.33 (95% CI: (0.15,0.73), I 2 = 82.61%). Six studies were found protective effects of wearing mask in non-HCWs (OR = 0.58, 95% CI: (0.31, 1.06), I 2 = 85.63%). Results suggest that there is association between face mask/PPE use and reduction of COVID-19.

Association between Age at Menarche and Metabolic Syndrome in Southwest Iran: A Population-Based Case-Control Study.

BACKGROUND: Age at menarche affects women's health outcomes and could be a risk factor for some diseases, such as metabolic syndrome (MetS). We assessed the association between age at menarche and MetS components in women aged 35-70 in Hoveyzeh, southwest Iran. STUDY DESIGN: A case-control study. METHODS: This case-control study was conducted on 5830 women aged 35-70 years in the Hoveyzeh cohort study (HCS), a part of the PERSIAN cohort study, from 2016-2018. The case group included women with MetS, while the controls were women without MetS. The MetS is determined based on standard NCEP-ATP III criteria. Data from demographic, socioeconomic, and reproductive history were gathered face-to-face through trained interviews. Moreover, laboratory, anthropometrics, and blood pressure measurements were assayed for participants. Multiple logistic regression was used to estimate the association between age at menarche and MetS, with adjustment for potential confounding variables. RESULTS: The mean age at menarche was 12.60 ± 1.76 years old. Urban and rural women differed in age at menarche (12.58 ± 1.71 and 12.63 ± 1.83 years, respectively). The study revealed a statistically significant relationship between MetS and menarche age. The odds of developing MetS were 14% higher in women with menstrual age ≤ 11 years than in other groups. CONCLUSION: As evidenced by the results of this study, the odds of having MetS were higher in women whose menarche age was ≤ 11 years. Furthermore, the association between MetS components and age groups at menarche was statistically significant.

Examining the diagnostic accuracy of common physical examination and functional tests in the diagnosis of patellofemoral pain syndrome among patients with anterior knee pain.

PURPOSE: The aims of this study were to evaluate the diagnostic accuracy of common physical examination and functional evaluation tests, and to determine a set of tests with the highest diagnostic accuracy for diagnosing patellofemoral pain syndrome (PFPS) in patients with anterior knee pain. METHODS: Based on careful evaluation of clinical findings and imaging methods by orthopedic physicians, 162 patients with anterior knee pain were classified into two groups of PFPS and non-PFPS. The physical examination and functional tests were performed by two physiotherapists. The accuracy of these measures was determined by calculating sensitivity, specificity, area under the receiver operating characteristic (ROC) curve (AUC), likelihood ratio (LR), and predictive value (PV). RESULTS: Our results showed the most sensitive tests in identifying patients with PFPS were as follows: eccentric step test [0.82 (95%CI: 0.72-0.89)]; palpation test [0.81(95%CI: 0.70-0.88)]; and prolonged sitting [0.73 (95%CI: 0.62-0.82)]. The palpation test, patellar tilt test, eccentric step test, navicular drop test, squatting, and stair descending tests had an acceptable accuracy (AUC ≥ 70). The strongest combination of the physical examination and functional tests included pain severity between 3 and 10 during stair descending test and pain severity between 6 and 10 during prolonged sitting test. This combination showed a positive LR of 19.47 (95% CI: 6.36-59.65) and a posttest probability of 95%. CONCLUSION: Our findings provide evidence for the good accuracy of the palpation test, patellar tilt test, eccentric step test, navicular drop test, squatting, and stair descending and prolonged sitting tests for diagnosing PFPS. Also, the combination of stair descending test and prolonged sitting test could be very useful for ruling in PFPS patients.

Validity and reliability of the Persian version of the STarT musculoskeletal tool.

BACKGROUND: The Subgrouping for Targeted Treatment (STarT) musculoskeletal (MSK) tool stratifies patients with MSK disorders (MSDs) into prognostic categories based on poor outcomes. PURPOSE: This study aimed at investigating the validity and reliability of the Persian STarT MSK tool in people suffering from painful MSDs in Iran. METHODS: A total of 593 subjects with painful MSDs including neck, shoulder, low back, knee, and multisite pain received and completed the STarT MSK tool, visual analog scale (VAS), EuroQol five-dimensions three-levels questionnaire (EQ-5D-3 L), short form-36 health survey questionnaire (SF-36), and Örebro musculoskeletal pain screening questionnaire (ÖMPSQ) in the first visit. To examine test-retest reliability, 234 patients completed the STarT MSK tool 2 days after the initial visit. RESULTS: In this study, 139 (23.5%), 266 (44.9%), and 188 (31.7%) participants were classified as low-, medium-, and high-risk groupings for poor outcomes, respectively. Spearman's correlation coefficient showed a strong relationship among Persian STarT MSK tool and EQ-5D-3 L (-0.78), SF-36 (-0.76), and OMPSQ (0.70). The results of known-group validity indicated that this tool could distinguish among the participants in different risk subgroups based on the scores of the ÖMPSQ, VAS, SF36, and EQ-5D-5 L (p < .001). No ceiling and floor effects were observed. Cronbach's alpha and intra-class correlation coefficient (ICC2,1) were acceptable (0.71) and excellent (0.98), respectively. CONCLUSION: The Persian version of STarT MSK tool has shown to be a valid and reliable instrument to stratify people with painful MSDs into low-, medium-, and high-risk subgroups based on persistent pain disability.

Comparing success of immediate versus delay loading of implants in fresh sockets: a systematic review and meta-analysis.

BACKGROUND AND AIMS: The replacement of teeth with osseointegrated implants is one of the significant advances in the field of restorative dentistry. The time interval between tooth extraction and the implant can be very short or long. This systematic review and meta-analysis aimed to collect and evaluate articles related to determining the effect of instant loading of dental implants are placed in the fresh socket initial stability on the clinical success of the implant compared to delay loading dental implants. MATERIALS AND METHODS: In this study, all the available articles indexed in leading databases, including PubMed, ISI Web of Science, Embase, PsycINFO, PROSPERO, and Scopus, were searched. The full text of the articles meeting the primary criteria to be included in this research was obtained and appraised. Data of studies were extracted if they were scored as a high or moderate level of evidence. RESULTS: A total of 2258 published articles were found through electronic database searching. After screening the titles and abstracts, and full text of articles, 16 studies met the inclusion criteria and were included in the analysis. The results of this study revealed that regarding the success rate, although there was no significant difference between immediate and delayed of dental implants, immediate procedure showed a lower incidence of bone loss in single implants. CONCLUSION: Based on the results of this study, immediate loading of dental implant, under certain conditions, is a successful treatment process and is effective in reducing treatment time. Thus, immediate loading represents a valid alternative to the traditional delayed loading rehabilitation.

Evaluation of the effect of a gel made with amniotic fluid formulation on the healing of diabetic foot ulcers: A triple-blind clinical trial.

Aim: The aim of this study was to evaluate the effect of a gel made with amniotic fluid (AF) formulation on wound healing in diabetic foot ulcers. Methods: This clinical trial was performed on 92 type 2 diabetic patients referring to the Diabetes Clinic of Golestan Hospital of Ahvaz, southwest of Iran in 2019-2020. Patients were randomly divided into three groups of intervention and one placebo group. The wounds of the three intervention groups were dressed with gauze impregnated with an AF formulation gel while wounds of the control group were dressed with plain gauze without any topical agent. Chi-square tests and generalized estimating equations (GEE) with a significance level of 0.05 were used to analyze the data. Results: At the end of the eighth week of intervention, there was a statistically significant difference among the four groups in terms of wound grade, wound color, condition of the tissues surrounding the wound, the overall condition of the wound, and the duration of wound healing (P < 0.05). Conclusions: Based on our experience with the patients in the present study, we believe that AF represents a useful and safe option for the treatment of chronic diabetic foot ulcers. Clinical trial registration: https://en.irct.ir/trial/51551, Identifier: IRCT20201010048985N1.

Pediculicidal Activity of Foeniculum vulgare Essential Oil in Treatment of Pediculus capitis as a Public Health Problem.

Background: Pediculosis, caused by Pediculus spp is an important public health problem in urban and rural areas around the world. Natural compounds such as plant essential oils (EOs) have been suggested as a potential alternative for insect pest control recently. The purpose of this study was to investigate the toxicity of Foeniculum vulgare essential oil against the head louse, Pediculus capitis under laboratory conditions. Methods: Fennel essential oil components were analyzed using GC-mass apparatus. Immersion and contact filter paper bioassays were used to evaluate fennel essential oil toxicity at the two-fold concentrations of 2.5, 5, 10, 20, and 40% against nit and nymph/adult stages of the head louse. Results: Trans-anethole, α-Thujone, and limonene, which consisted of 76.08%, 10.37%, and 5.34% were the most components of fennel oil respectively. The LC50 values for the adult /nymphs were 11.5, 6.4, 3.9, 3.1 and 2.5% and LC99 values were 29.5, 15.2, 12.8, 10.8, and 7.4% at 10, 20, 30, 45 and 60 minutes after exposure respectively. The lethal times (LT50) for adults/nymphs were 5.2, 8.1, 9.5, 20.5, and 45.8 minutes and LT99 were 138.6, 91.3, 23.8, 21.7, and 13.9 minutes in the concentrations of 2.5, 5, 10, 20 and 40%, respectively. LC50 and LC99 values were 2.32% and 7.36% after 5 days for the eggs. Conclusion: Fennel essential oil at the concentration of 15% after 20min is suggested to develop as an appropriate formulation to evaluate in clinical trials.

Application of Bayesian Decision Tree in Hematology Research: Differential Diagnosis of ß-Thalassemia Trait from Iron Deficiency Anemia.

OBJECTIVE: Several discriminating techniques have been proposed to discriminate between ß-thalassemia trait (ßTT) and iron deficiency anemia (IDA). These discrimination techniques are essential clinically, but they are challenging and typically difficult. This study is the first application of the Bayesian tree-based method for differential diagnosis of ßTT from IDA. METHOD: This cross-sectional study included 907 patients with ages over 18 years old and a mean (±SD) age of 25 ± 16.1 with either ßTT or IDA. Hematological parameters were measured using a Sysmex KX-21 automated hematology analyzer. Bayesian Logit Treed (BLTREED) and Classification and Regression Trees (CART) were implemented to discriminate ßTT from IDA based on the hematological parameters. RESULTS: This study proposes an automatic detection model of beta-thalassemia carriers based on a Bayesian tree-based method. The BLTREED model and CART showed that mean corpuscular volume (MCV) was the main predictor in diagnostic discrimination. According to the test dataset, CART indicated higher sensitivity and negative predictive value than BLTREED for differential diagnosis of ßTT from IDA. However, the CART algorithm had a high false-positive rate. Overall, the BLTREED model showed better performance concerning the area under the curve (AUC). CONCLUSIONS: The BLTREED model showed excellent diagnostic accuracy for differentiating ßTT from IDA. In addition, understanding tree-based methods are easy and do not need statistical experience. Thus, it can help physicians in making the right clinical decision. So, the proposed model could support medical decisions in the differential diagnosis of ßTT from IDA to avoid much more expensive, time-consuming laboratory tests, especially in countries with limited recourses or poor health services.

A study of mindfulness-based stress-reduction training effects on menopause-specific quality of life in postmenopausal women: A randomized controlled trial.

OBJECTIVES: Physical and psychological changes in most postmenopausal women tend to lower their quality of life. Various medical/psychological interventions have been applied to improve the postmenopausal quality of life. This study set out to investigate the effect of Mindfulness Based Stress Reduction (MBSR) training on the Menopause-specific quality of life (MENQOL). METHODS: This RCT was conducted on 66 postmenopausal women aged 47-62 in Iran. Participants were randomly assigned to either the MBSR or the control group. The menopause--specific quality of life was assessed in two groups via MENQOL questionnaire prior to, immediately and three months after the intervention. RESULTS: The findings revealed a significant improvements in MENQOL (P < 0.001),as well as physical(P = 0.001), psychosocial(P = 0.001) and sexual(P < 0.001)dimensions of the intervention groups compared to the control group, immediately and 3 months after the intervention. CONCLUSION: MBSR program can be safely applied to improve menopausal women's quality of life and curb the postmenopausal symptoms. TRIAL REGISTRATION NUMBER: IRCT2015072523344N1.

Development and Psychometric Assessment of Nursing Student's Satisfaction with First Clinical Practical Education Questionnaire: Modified Version.

BACKGROUND: The present study aimed to develop an instrument for assessing nursing students' satisfaction with First Clinical Practical Education (SFCPE), and then to test the validity and reliability of the instrument. MATERIALS AND METHODS: In this methodological research, the views of a panel of 15 clinical professors, in terms of the clinical nursing principles and skills training, were used to develop the instrument. The content validity of the instrument was evaluated quantitatively and qualitatively based on the panel's views. The data was collected from the questionnaire completed by 380 second- and third-semester nursing students in 15 medical universities of Iran. The Exploratory Factor Analysis (EFA) was later performed to determine the construct validity of the instrument. The reliability of the instrument and stability analysis were evaluated using the internal consistency test by calculating Cronbach's alpha and by the test-retest method, respectively. RESULTS: Throughout the development phase, 16 items were added to the SFCPE instrument, and a 42-item instrument was later developed. During the qualitative and quantitative content validity reviews, the number of added items decreased to 38 items. Finally, a 37-item instrument consisting of seven factors was developed. The Cronbach's alpha coefficients of 0.95 and 0.75-0.9 were obtained for the whole instrument and the factors, respectively. Pearson's correlation coefficient was within the normal range (0.71-1). CONCLUSIONS: The developed SFCPE is a valid and reliable instrument that can be used for assessing the satisfaction of nursing students in terms of clinical nursing principles and skills.

Co-existence of mutations in myeloproliferative neoplasms and their clinical significance: a prognostic approach.

OBJECTIVE: Myeloproliferative neoplasms (MPNs) are a group of clonal hematopoietic stem cell disorders that may occur after one or more mutations in hematopoietic progenitor cells. In this study, we will review the co-existence of mutations (especially dual mutations) in MPNs and its effect on the prognosis of patients. METHODS: To find relevant published papers, we systematically searched six major international indexing databases, namely PubMed/Medline, EmBase, Cochrane central, ISI web of science, and Scopus from Feb. 2000 until Jan. 2020. We included the following keywords in the analyzes: Myeloproliferative Disorders, Mutation, Co-existence of Mutations, Acute myeloid leukemia. RESULTS: Co-existence of several mutations in MPNs is mainly associated with a poor prognosis compared with the unimutated MPN disorders. There are several effective factors such as sequence of mutations, incidence of mutations in one cell or different cells, mutation, and MPN type. CONCLUSION AND EXPERT COMMENTARY: It seems that monitoring the status of mutations in MPNs and recognizing the co-existence of mutations (especially dual mutations) in order to determine prognosis and possibility of progression to acute form of leukemia can lead to the prediction of prognosis in MPN patients as well as establishment of better and more reliable therapeutic strategies for patients.

Prevalence and Spatial Distribution of Bed Bug, Cimex lectularius, Infestation in Southwest of Iran: GIS Approach.

BACKGROUND: The common bed bug, a nocturnal bloodsucking insect, is known as a human parasite and public health problem in the world. The prevalence and geographical dispersion of bed bug in Ahvaz City, southwest of Iran was measured. METHODS: Spatial distribution of Cimex lectularius was determined by surveying 520 houses in 62 areas of Ahvaz City in 2017. Some information like as infested points, the concern level of the residents and allergic reaction to the insect bite were registered in a form using the secondhand instrument. RESULTS: According to the spatial distribution map, of 62 areas, 27 of them are infested with bed bugs. Infestation is scattered throughout the city, but its focus is on the east of the Karun River. The most bed bug infestation was in Asiabad followed by Manbaab areas. Prevalence of bed bug infestation estimated 9.61% in Ahvaz city. It was 5.4% and 11.6% in apartments and single houses, respectively. The lowest and highest infestation rates based on its source were 1.35% and 9.03% in wallpaper and cracks and crevices, respectively. Bedroom and sitting room were the main harborages for bed bug in the houses. The majority of residents who had bitten by a bed bug showed various allergic reactions like redness skin, papules, vesicles, pustules and blisters. Most of the people in the infested houses (62%) were very concern about bed bug infestation. CONCLUSION: Public education and increasing the knowledge of people can lead to successful management, prevention and elimination of this nuisance pest.

Prognostic role and therapeutic susceptibility of cathepsin in various types of solid tumor and leukemia: A systematic review.

Cathepsins (CTSs) are multifunctional proteins that can play prominent roles in cancer progression and metastasis. In this systematic review, we compared the prognosis of CTS subtypes overexpression in leukemia and solid tumors, and investigated the effect of different factors on CTS prognosis. We systematically searched published articles indexed in PubMed, Scopus, Cochrane library, ISI Web of Science, and EmBase databases from February 2000 until January 2020. Among the selected leukemia and solid tumors studies, overexpression of CTS subtypes in newly diagnosed and treated patients were with poor prognosis in 43 studies (79.6%) and with good prognosis in 9 studies (16.6%). However, there were 2 studies (3.8%) with either good or poor prognosis, depending on conditions and caner stage and host cell. The relation between CTS and human leukocyte antigen (HLA) in leukemia and solid tumors was mentioned in 7 studies (13%). Overexpression of CTS subtypes in all new case patients had contributed to the induction of poor prognosis. It seems that CTS subtypes, based on the type of cancer and its stage, the type of host cells, and the probable relation with HLA, breed good or poor prognosis in patients with cancer. Therefore, monitoring the overexpression of CTS subtypes and determining the effect of each of these factors on CTS prognosis could be helpful in predicting cancer prognosis both in newly diagnosed or under treatment patients. They could also be useful in finding ways for improving the efficiency of contemporary therapeutic strategies in various types of leukemia and solid tumors.

Effect of Ginger Powder Supplementation in Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver disorders. The main causes of NAFLD are associated with insulin resistance, severe lipid metabolism disorders, oxidative stress and inflammation. Previous studies have reported that ginger has positive metabolic results. AIM: The aim of this study was to determine the effect of ginger powder supplement on lipid profiles, insulin resistance, liver enzymes, inflammatory cytokines and antioxidant status in patients with NAFLD. METHODS: In this randomized clinical trial, 46 people with NAFLD were parted into two groups and subjected to the ginger or placebo capsules (3 capsules daily, each containing 500 mg of ginger or wheat flour) over 12 weeks. All patients received a diet with balanced energy and physical activity during the intervention period. Liver ultrasonography, anthropometric indices and biochemical parameters were measured before and after intervention. RESULTS: No significant difference was found between the two groups in the baseline variables at the beginning of the study. At the end of the study, serum levels of alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein (LDL-C), fasting blood glucose, and insulin resistance index (HOMA), C-reactive protein (hs-CRP), and fetuin-A in the group receiving a ginger supplement significantly decreased compared to placebo. However, there was no significant difference between the two groups in body weight, fasting insulin, HDL-C, triglyceride, adiponectin, alpha-tumor necrosis factor (TNF-α), total antioxidant capacity (TAC), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), fatty liver index (FLI), fatty liver grade and blood pressure. CONCLUSION: The ginger supplement may be used as a complementary therapy along with existing therapies to reduce insulin resistance, liver enzymes and inflammation in patients with non-alcoholic fatty liver.

Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran.

Background: The Hoveyzeh cohort study (HCS) is a population-based cohort study that conducted in Hoveyzeh County (South-west Iran). HCS focus on common chronic diseases, disorders and risk factors of NCDs in the Arab ethnicity. Methods: A total number of 10009 participants (35-70 years old) were recruited in this prospective cohort study from May 2016 to August 2018. The HCS data were gathered by trained interviewer through interviewer-administered questionnaires. Also anthropometric measurements, physical examinations, clinical assessments, ophthalmology evaluation, auditory examinations, respiratory and cardiovascular assessments was conducted by means of standard instruments. Biological samples including blood, urine, hair, and nail collected and stored in the biobank. Results: The overall participation rate was 82.7%. The prevalence of obesity was 27.4% in males and 47% in females. Cigarette smoking prevalence was 20.9% (40.6 % in men and 7.6 % in women). Prevalence of major non communicable diseases such as diabetes, hypertension, metabolic syndrome, cardiac ischemic, myocardial infarction and stroke was 22.2%, 26.4% 31.9 %, 13.6%, 1.85% and 1.6% respectively. Conclusion: Considering the high prevalence of obesity and smoking in the population of Hoveyzeh and since the important role of these risk factors in development of common non communicable diseases, this issue should be taken into consideration and the necessary interventions in this context must be considered to modify lifestyle. The HCS is the only comprehensive cohort in the region, enabling it to provide valuable evidence about NCDs for a wide geographical area covering millions of people in both Iran and Iraq.

Comprehensive physical domain care needs of burn patients: a qualitative study.

INTRODUCTION: Burn patients have various physical needs. To provide full care for such patients, we need a broad range of services. The current study aims at showing the physical needs of burn patients. METHODS: The current qualitative study has been done through content analysis. The data were collected from 20 in-depth, unstructured individual interviews with hospitalized patients with burns on more than 25% of their body, nurses, physiotherapists, and psychologists. The participants were selected by purposive sampling. The data were analyzed with a conventional content analysis approach using the Elo and Kyngas method. RESULTS: By analyzing the data, 7 main categories were obtained from 932 primary codes: the necessity to provide optimal physiotherapy, the necessity of the patient's overall physical assessment, the necessity of monitoring and coordination in care, healthy nutrition for burn patients, the need for pharmacotherapy, the need for pain reliefs, and finally the theme for comprehensive physical care needs in burn patients. CONCLUSION: According to the findings, by applying the extracted categories, it is possible to provide quality care based on the patient's individual needs. This can help speed up the treatment and shorten the length of hospitalization significantly.

Pediculosis humanus capitis Prevalence as a Health Problem in Girl's Elementary Schools, Southwest of Iran (2017-2018).

BACKGROUND: Head lice as obligated ectoparasite is a public health concern. We aimed to determine the prevalence of Pediculus humanus capitis as public health concern among girl's primary school in southwest of Iran. STUDY DESIGN: A cross-sectional study. METHODS: This study was conducted in Karoon County, south-west of Khuzestan Province in Iran in 2017-2018. Totally, 851 students were interviewed randomly, examined by a medical entomologist and completed a questionnaire containing 18 questions based on individual, social, economic, cultural and health information. Results were presented as prevalence and percentages for qualitative variables and also, the data were analyzed by univariate logistic and multivariate regression models. RESULTS: About 199 (23.38%) girls were infected by head lice. Univariate logistic regression indicated that the prevalence of pediculosis was directly associated with the grade of education, father's job, shared personal hygiene products, number of combing, having permanent head cover at home, infection in other members of the family and previous infection. Multivariate logistic regressions for predicting of head lice infection in girl students were reported permanent head cover at home (OR: 1.399, 95% CI: 0.934, 2.097, P=0.104), grade of education (OR: 1.948, 95% CI: 1.307, 2.905, P=0.001), father's job (OR: 2.385, 95% CI: 1.518, 3.750, P<0.001), shared personal hygiene products (OR: 1.817, 95% CI: 1.224, 2.698, P=0.003) and using hair oil (OR: 1.904, 95% CI: 1.279, 2.836, P=0.002) had significant relation with head lice infestation CONCLUSION: Head lice remind as serious health problem in Karoon County, southwest of Iran. Due to high infestation, periodic screening of the student is recommended for early detection and treatment.